Healthcare Provider Details

I. General information

NPI: 1033439005
Provider Name (Legal Business Name): ERICK LEOPOLDO MONTERO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2010
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24411 HEALTH CENTER DR SUITE 680
LAGUNA HILLS CA
92653-3651
US

IV. Provider business mailing address

17360 BROOKHURST ST ATTN: MCMF - CREDENTIALING DEPARTMENT
FOUNTAIN VALLEY CA
92708-3720
US

V. Phone/Fax

Practice location:
  • Phone: 949-268-4568
  • Fax: 949-455-2795
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberM-14457
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberA85344
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: